CASE 1. RINGWORM AND POSSIBLY OPEN PYOMETRA
"Can you remember this dog?" the man in his late 20s put the Maltese X with fully formed cataracts in her eyes on the consultation table.
"No," I said. "It is not easy to identify Malteses or their crosses as they look almost alike."
"In June, you extracted her right tooth which you said was infected with pus," the man said as I referred to the medical records.
"Yes," I said. "This 15-year-old must be the oldest dog in Singapore to suffer from an oro-nasal fistula. How is she now?"
"No more problem," the man showed me the right side of the face. Hair had fully grown and as I tried to open the dog's mouth, she turned her head away. The owner tried but was not successful. The old dog remembered the pain and was avoiding the pain.
"What's her problem today?" I asked.
"She is itchy and keeps rubbing her back on the floor."
The dog's back was losing hair compared to the fullness of hair on the face.
I put some of the back hairs under the microscope. "There is ringworm in the hairs," I asked the young man to view the hairs.
"Does the dog lick her private parts?" I asked. "See the vulval area. It is swollen and is 10 times larger than normal."
"I don't think so. She only licks her thighs," he said.
"To you, it appears that the thighs are itchy as well." I said. "She has some infections, either in the womb as she is not spayed or in the bladder. As she is so old, I would not advise spaying. If spaying had been done at a young age, we could be sure that the dog would not be suffering from infections of the womb or have ovarian cysts or tumours."
Due to economic reasons, I did not advocate more tests. The owner wanted to clip the dog himself as he had bought a clipper. "It is not that easy for you to shave her completely bald," I said. "You can't even open her mouth for me to examine her teeth." I had not forced this old dog to open her mouth this time as her main problem was the skin. It would be prudent to check the mouth but then she had her dental work and scaling just 6 months ago and had no bad breath. So, I spared her the agony.
What's the cause of the skin itchiness? Although ringworm is a primary cause in the back skin, there may be a more serious problem. It is likely that this 15-year-old dog has open pyometra. She keeps leaking out pus from her vagina. She licks off the discharge to be clean. So the irritated vulval lips become swollen 10X over the past few days or weeks. To the owner, she is just having itchy thighs and back area.
TIPS: Spay your female dog when she is young. If she lives to 15 years, she will not be having pyometra.
Her oro-nasal fistula case is recorded at:
http://www.bekindtopets.com/dogs/20100615oro_nasal_fistula_carnaissal_tooth_abscess_old_dog_ToaPayohVets.htm
CASE 2.
"What are those bluish lumps?" the young lady asked me. "I check my dog daily and saw them last week." The soft lumps under the skin were present between MG4 and MG5 on the left side. MG = Mammary Gland (breasts).
"They are breast tumours," I said. "The lumps may be cancerous if they grow fast."
"What to do?"
"Surgery to remove them while they are small in size," I said. "If they are cancerous, they will spread to the other breasts or grow to big sizes like ping-pong balls.
As the lady was worried about anaesthesia, she chose to have a complete blood test done to check whether her dog was healthy. "Whether she is healthy or not," I said. "Your dog needs surgery if the breast tumours grow big and fast. It will be too late if you wait another few weeks."
TIPS
Early spay will usually not result in breast tumours in the female dog in the majority of cases.
Wednesday, November 24, 2010
Tuesday, November 23, 2010
252. Misperceptions
"You must have a rich father to be able to study veterinary medicine in Scotland?" the project officer of similar age to mine, said. 30 years ago, one British pound was 8 Singapore dollars and those who studied overseas were from wealthy families.
"No," I said. "I was fortunate that the British Government gave the Colombo Plan Scholarship to enable me to study veterinary medicine in Glasgow University, Scotland. Now, Singapore has become a developed country and is in a position to offer ASEAN scholarships to students so that they can go home to help their country people."
I met him and his boss (a younger man in the family business) yesterday Nov 22, 2010 as my friend Khin Khin, asked me to be present to help her in her discussions about export Myanmar sand to Singapore. The Singapore English, thinking and culture of business is clearer to me than to her and so I was useful to her. The JTC would be tendering to buy sand on Dec 3, 2010 and Khin Khin was anxious to close a deal as an agent. If successful in getting 5 million cubic tonnes of sand for 18 months, she could get a commission of some $200,000/cubic tonne or some large figures. It sure beats spaying a dog for $200.00 as I will need to spay every dog in Singapore, probably.
Personally, I am not interested in this wheeling and dealing as it waste a lot of time. But I do attend some of Khin Khin's meetings and I do meet interesting characters for my stories. At the meeting, I will write notes for Khin Khin as she listens and learns the tricks of the commodity agency trade. For the past two years, she has not closed a deal. Well, I better stick to veterinary medicine.
After the meeting, the project officer invited us to have some coffee. Khin Khin had to go and I stayed behind to socialise with him and his boss. This boss is a young man and I said: "You must be driving a Lamborghini or a Ferrari," I had the impression that he was the type who would be doing it since his business must be successful. Supplying sand to the JTC is big business and if he can think of doing it, he must have the financial backup as there are financial performance bonds and penalties. He said that the freight cost of importing the sand from Myanmar to Singapore would cost more than the sales price of sand, which if rejected by the JTC would cost him a lot of money. That meant that he has the sufficient funds to undertake this venture.
"No, no," the young man said. "I drive a BMW."
The project officer said: "He would be buying a Lamborghini soon."
I was impressed.
"Well, I put in a bid when the LTA auctions the car," the young man said. "The LTA (Land Transport Authority) caught its senior manager milking it millions of dollars and is trying to recover some monies back by selling this senior manager's Lamborghini soon."
As a car depreciates in value, the LTA can't wait till the end of the court case to sell this car. This young man may be lucky to get a Lamborghini at below market price!
"No," I said. "I was fortunate that the British Government gave the Colombo Plan Scholarship to enable me to study veterinary medicine in Glasgow University, Scotland. Now, Singapore has become a developed country and is in a position to offer ASEAN scholarships to students so that they can go home to help their country people."
I met him and his boss (a younger man in the family business) yesterday Nov 22, 2010 as my friend Khin Khin, asked me to be present to help her in her discussions about export Myanmar sand to Singapore. The Singapore English, thinking and culture of business is clearer to me than to her and so I was useful to her. The JTC would be tendering to buy sand on Dec 3, 2010 and Khin Khin was anxious to close a deal as an agent. If successful in getting 5 million cubic tonnes of sand for 18 months, she could get a commission of some $200,000/cubic tonne or some large figures. It sure beats spaying a dog for $200.00 as I will need to spay every dog in Singapore, probably.
Personally, I am not interested in this wheeling and dealing as it waste a lot of time. But I do attend some of Khin Khin's meetings and I do meet interesting characters for my stories. At the meeting, I will write notes for Khin Khin as she listens and learns the tricks of the commodity agency trade. For the past two years, she has not closed a deal. Well, I better stick to veterinary medicine.
After the meeting, the project officer invited us to have some coffee. Khin Khin had to go and I stayed behind to socialise with him and his boss. This boss is a young man and I said: "You must be driving a Lamborghini or a Ferrari," I had the impression that he was the type who would be doing it since his business must be successful. Supplying sand to the JTC is big business and if he can think of doing it, he must have the financial backup as there are financial performance bonds and penalties. He said that the freight cost of importing the sand from Myanmar to Singapore would cost more than the sales price of sand, which if rejected by the JTC would cost him a lot of money. That meant that he has the sufficient funds to undertake this venture.
"No, no," the young man said. "I drive a BMW."
The project officer said: "He would be buying a Lamborghini soon."
I was impressed.
"Well, I put in a bid when the LTA auctions the car," the young man said. "The LTA (Land Transport Authority) caught its senior manager milking it millions of dollars and is trying to recover some monies back by selling this senior manager's Lamborghini soon."
As a car depreciates in value, the LTA can't wait till the end of the court case to sell this car. This young man may be lucky to get a Lamborghini at below market price!
Monday, November 22, 2010
242. Art entrepeneurship
Singapore has so many events that it is impossible to keep track of them when one is inside the surgery attending to cases. There is simply no time. Apart from veterinary medicine and surgery, I am interested in art and read many of the art magazines in the public libraries. It is just too expensive to subscribe to them.
One day, I was at the HDB Hub and there was "Global Entrepreneurship Week 2010" held by ACE - Action community for entrepreneurship and NUS - National University of Singapore.
I was surprised to see a booth about to close shop for the day. It is Artyii (www.artyii.com). The founders of this start up (incorporated in 2009) market artists and Asian art.
It helps artists to market their works online and manage framing, shipping and payment. Marketing is important as many emerging or unknown artists seldom can afford to do their own marketing and distribution. They rely on the support of art gallery owners who may not be interested in their arts. It is like new authors, e.g. Harry Potter, having great difficulty in finding a publisher when he or she is unknown.
Artyii focuses on Asian artists (not photographers, I was told). The company targets global buyers and have received strong European interest. "Do you have any marketplace art of Myanmar artists?" I asked Ms Ng Cai Lin, one of 3 founders. "No," she said. "There is a lady doing this." She was quite good in e-mailing to me some market artwork from Vietnam. Following up and keeping in contact with prospect is one of the factors of success in an enterprise.
I remember this young Myanmar lady whose concept is to market Myanmar artwork at the Art House in Singapore in 2008 and 2009. It is very expensive to do it. Now this must be the lady Ms Ng mentioned. I bought one small piece of artwork from her. I am looking for marketplace artwork but she has not many.
Being an art gallery offline is very expensive due to the high rentals in Singapore and therefore an online art gallery such as Artyii is a good concept. Ar5tyii's website was launched in August 2010 and has around 100 artists from Singapore, Vietnam, Indonesia and India showcasing over 400 original artworks.
From what I read in an Arts magazine, there is a similar concept in New York or California. It is like a co-operative for artists and helps them to sell art online. It helps them by storing some of their artwork so that they don't sell them at a great loss when they need morning. I can't remember this website.
CONCLUSION
1. Is there an online concept for photographers? I think there are but don't know any of them.
2. Is there an online concept for educational photographs in veterinary medicine and surgery? I know there a beautiful and expert textbook illustrators in medicine but am not aware of any online art gallery for this topic. Readers who know, please e-mail to me. Textbook illustrations don't reach a global audience and the beautiful textbooks are quite expensive and hard to find. I found one Singapore publisher printing such books but they are for the University and are very costly.
One day, I was at the HDB Hub and there was "Global Entrepreneurship Week 2010" held by ACE - Action community for entrepreneurship and NUS - National University of Singapore.
I was surprised to see a booth about to close shop for the day. It is Artyii (www.artyii.com). The founders of this start up (incorporated in 2009) market artists and Asian art.
It helps artists to market their works online and manage framing, shipping and payment. Marketing is important as many emerging or unknown artists seldom can afford to do their own marketing and distribution. They rely on the support of art gallery owners who may not be interested in their arts. It is like new authors, e.g. Harry Potter, having great difficulty in finding a publisher when he or she is unknown.
Artyii focuses on Asian artists (not photographers, I was told). The company targets global buyers and have received strong European interest. "Do you have any marketplace art of Myanmar artists?" I asked Ms Ng Cai Lin, one of 3 founders. "No," she said. "There is a lady doing this." She was quite good in e-mailing to me some market artwork from Vietnam. Following up and keeping in contact with prospect is one of the factors of success in an enterprise.
I remember this young Myanmar lady whose concept is to market Myanmar artwork at the Art House in Singapore in 2008 and 2009. It is very expensive to do it. Now this must be the lady Ms Ng mentioned. I bought one small piece of artwork from her. I am looking for marketplace artwork but she has not many.
Being an art gallery offline is very expensive due to the high rentals in Singapore and therefore an online art gallery such as Artyii is a good concept. Ar5tyii's website was launched in August 2010 and has around 100 artists from Singapore, Vietnam, Indonesia and India showcasing over 400 original artworks.
From what I read in an Arts magazine, there is a similar concept in New York or California. It is like a co-operative for artists and helps them to sell art online. It helps them by storing some of their artwork so that they don't sell them at a great loss when they need morning. I can't remember this website.
CONCLUSION
1. Is there an online concept for photographers? I think there are but don't know any of them.
2. Is there an online concept for educational photographs in veterinary medicine and surgery? I know there a beautiful and expert textbook illustrators in medicine but am not aware of any online art gallery for this topic. Readers who know, please e-mail to me. Textbook illustrations don't reach a global audience and the beautiful textbooks are quite expensive and hard to find. I found one Singapore publisher printing such books but they are for the University and are very costly.
250. An English Literature graduate
I felt that this English literature graduate in her 30s must have loved literature in order to study this subject in her university. A vet must love veterinary medicine to study this subject and then become a real vet. However this literature graduate did not practise her craft in the sense that I would expect her to write and author books. She has no children and so would have much more time than those successful authors. I guess she has no motivation or passion.
Passion is important but will not sustain you in being successful. Without passion, you will not need be successful.
I refer to an article written by Mr Ho Kwon Ping, Executive Chairman, Banyan Tree Holdings Limited in the Straits Times, Nov 15, 2010 Page B11 - Our new generation of entrepreneurs - can they make it big?
He said that passion is necessary but will not be a sufficient attribute for success. Cash flow is the highest priority in an enterprise and that comes from long hours of hard work if the start up does not fail. If it succeeds, how do you scale up your business to become global?
FACTS OF BUSINESS
It is well known that less than 20% of start ups will succeed. This failure rate of 80% is especially true in a free and competitive economy of Singapore. Nobody can predict which start up will succeed or fail. First ventures are seldom successful and the entrepreneur needs to use this failure as a learning lesson.
SUSTAINABILITY
1. Does sustainability when successful depend on scalability? "The search for scalability is the holy grail of entrepreneurs," Mr Ho wrote. Therefore successful small business must leave Singapore which is a very small domestic market and into the streets.
2. Street-smarts - whatever they mean, is another important attribute for sustainability. IPC, a computer company and Creative Technology are 2 examples of early successes which could not be sustained overseas. Yeo Hiap Seng and Osim acquired a seafood canning company and consumer gifts chain respectively but had written off their investment. Niche markets may be successful as in Coffeemix in West Asia, Breadtalk and some foodcourt operators in China and Asian shopping malls. Olam is being a bridge using their supply chain expertise in commodity processing to bring commodities from the developing world to developed markets.
CONCLUSION
Find a niche to excel and focus on innovations as product life spans are short in information technology or consumer products which are dominated by global giants where scale is critical.
To globalise, change your mindset by not comparing things done in Singapore. Respect and promote a culture of diversity to be resilient when you manage externai businesses.
No destination but a journey. Size and success in a business can dissppear quickly due to lak of attention and hubris. One-trick companies don't succeed in the long term.
In reply to the question in the essay, Mr Ho said that our entrepreneurs can make it big but only a few of them. Practice makes perfect and failure begets sucess.
Sometimes, it may just be better to be an employee, in my opinion as enterprises have a high failure rate even though they are successful. A small number of vet surgeries have had closed down but more than 40 have been opened in recent years. It will take a long time to succeed. There is no short cut in any enterprise.
Passion is important but will not sustain you in being successful. Without passion, you will not need be successful.
I refer to an article written by Mr Ho Kwon Ping, Executive Chairman, Banyan Tree Holdings Limited in the Straits Times, Nov 15, 2010 Page B11 - Our new generation of entrepreneurs - can they make it big?
He said that passion is necessary but will not be a sufficient attribute for success. Cash flow is the highest priority in an enterprise and that comes from long hours of hard work if the start up does not fail. If it succeeds, how do you scale up your business to become global?
FACTS OF BUSINESS
It is well known that less than 20% of start ups will succeed. This failure rate of 80% is especially true in a free and competitive economy of Singapore. Nobody can predict which start up will succeed or fail. First ventures are seldom successful and the entrepreneur needs to use this failure as a learning lesson.
SUSTAINABILITY
1. Does sustainability when successful depend on scalability? "The search for scalability is the holy grail of entrepreneurs," Mr Ho wrote. Therefore successful small business must leave Singapore which is a very small domestic market and into the streets.
2. Street-smarts - whatever they mean, is another important attribute for sustainability. IPC, a computer company and Creative Technology are 2 examples of early successes which could not be sustained overseas. Yeo Hiap Seng and Osim acquired a seafood canning company and consumer gifts chain respectively but had written off their investment. Niche markets may be successful as in Coffeemix in West Asia, Breadtalk and some foodcourt operators in China and Asian shopping malls. Olam is being a bridge using their supply chain expertise in commodity processing to bring commodities from the developing world to developed markets.
CONCLUSION
Find a niche to excel and focus on innovations as product life spans are short in information technology or consumer products which are dominated by global giants where scale is critical.
To globalise, change your mindset by not comparing things done in Singapore. Respect and promote a culture of diversity to be resilient when you manage externai businesses.
No destination but a journey. Size and success in a business can dissppear quickly due to lak of attention and hubris. One-trick companies don't succeed in the long term.
In reply to the question in the essay, Mr Ho said that our entrepreneurs can make it big but only a few of them. Practice makes perfect and failure begets sucess.
Sometimes, it may just be better to be an employee, in my opinion as enterprises have a high failure rate even though they are successful. A small number of vet surgeries have had closed down but more than 40 have been opened in recent years. It will take a long time to succeed. There is no short cut in any enterprise.
Sunday, November 21, 2010
The dog with white gums
In January 2010, I wrote an article on a case of Closed Pyometra in a female dog. The blood test shows anaemia and toxaemia in a female dog with pyometra. See the webpage at Pyometra - very low platelet count due to toxic blood.
URL is at:
http://www.bekindtopets.com/dogs/20100135Video_Education
_Closed_Pyometra_ToaPayohVets.htm
In November 2010, I had a very interesting case of a spayed female Miniature Schnauzer, 10 years old, losing 25% weight and not eating much for the last 3 months. When I saw the dog's gums, tongue and oral mucous membranes as white as snow, I predicted that this dog would not live past the next 7 days. I gave her intensive IV drip including glucose, saline, protein drip, multi-vitamins and Vit K1. An iron and Vit B complex injection SC was given. Baytril and metronidazole were given IV.
I took blood for analysis before and 24 hours after the IV and injections. The platelet count had dropped much further from 68 to 1. Yet 24 hours after the IV drip, the dog's gums and tongue were purplish pink in colour. I showed the colour to the lady owner. She was not impressed as she could not recall the snow-white colour 24 hours ago. I did not take a picture but I do remember telling her that the dog was very pale and anaemic.
She had been too stressed out by a bereavement in her family and now this dog was going to die.
Nov 11, 10 First consultation
Nov 12 24, 10 hours after IV
Ref Range
Unit
Total White Cells
12.8
6.6
6 - 17
x10>9/L
Total Red Cells
4
3.9
5.5 - 8.5
X10>12/L
Haemoglobin
9.7
9.6
12-18
g/dL
Platelets
68
1
200-500
x10>9/L
The dog survived and is well nursed by the lady owner as at Nov 21, 2010. As to the cause, I told her it was difficult to say. The cause would likely be a viral and bacterial cause. The dog had not been vaccinated since she was a puppy and was brought for walks in the past year whereas previously the dog was home most of the time.
BACKGROUND HISTORY OF THIS DOG RECORDED BY ME IN NOV 15, 2010
AT DEATH'S DOOR. THE DOG WITH WHITE GUMS
The thin, hunch-backed 10-year-old Miniature Schnauzer with white gums would not eat. She had been treated 4 times by Vet 1. ACTH tests were normal. Ultrasound indicated possible tumours of the liver, pancreas and spleen. So, the owner was very worried and wanted surgery.
"The dog is not fit for surgery," I advised. "She will just die on the operating table. Look at the white gums. She has severe anaemia. I will do a blood test."
The anaemia was due to low red cell count, low haemoglobin and very low platelet count. She was attended to by Vet 1 from August to November for 4 times and was not eating when the owner consulted me, being referred to by one of my clients.
Incredibly, after an intensive IV drip of saline, glucose, protein, Vit K1, antibiotics including baytril and metronidazole, B complex and iron injections s/c, the dog that lost 1 kg (25% of her weight in the last 4 weeks) was thriving. "She ate a lot and pooped a lot for the last 2 days," the young lady said. "Today, she is not eating. Shall I give her the Re... from Vet 1? It is said to improve her appetite."
What was the cause of this severe anaemia and the low platelet count? I suspect it was either some drugs or septic infection (from virus or bacteria) when the dog was brought downstairs in recent weeks.
During the first consultation with me, the dog screamed when I pressed the very painful disc pain at T/L area and bit me when I palpated the moderately enlarged left submandibular and popliteal lymph node. Her bladder was painful on palpation. Her left kidney was slightly painful. Her left tongue had some ulcers at the back and I took digital pictures to show the owner.
So what was happening to this dog? The lady had only one wish - that this dog would not die on her as she had a recent family bereavement. Yet, the dog's gums were as white as snow when I saw her at first. I did not take a picture then but her gums became a bit pinker 24 hours after the intensive care and injections. So, this dog had come back from death's door. But she is not out of the woods yet. Only time will tell.
UPDATE: No complaints from the young lady. I phoned her twice and the dog was getting better. Short episodes of panting which I attributed to pain in the spinal area. I asked her to give pred 2.5 mg two times per day. No more news from her. No news is good news, usually.
URL is at:
http://www.bekindtopets.com/dogs/20100135Video_Education
_Closed_Pyometra_ToaPayohVets.htm
In November 2010, I had a very interesting case of a spayed female Miniature Schnauzer, 10 years old, losing 25% weight and not eating much for the last 3 months. When I saw the dog's gums, tongue and oral mucous membranes as white as snow, I predicted that this dog would not live past the next 7 days. I gave her intensive IV drip including glucose, saline, protein drip, multi-vitamins and Vit K1. An iron and Vit B complex injection SC was given. Baytril and metronidazole were given IV.
I took blood for analysis before and 24 hours after the IV and injections. The platelet count had dropped much further from 68 to 1. Yet 24 hours after the IV drip, the dog's gums and tongue were purplish pink in colour. I showed the colour to the lady owner. She was not impressed as she could not recall the snow-white colour 24 hours ago. I did not take a picture but I do remember telling her that the dog was very pale and anaemic.
She had been too stressed out by a bereavement in her family and now this dog was going to die.
Nov 11, 10 First consultation
Nov 12 24, 10 hours after IV
Ref Range
Unit
Total White Cells
12.8
6.6
6 - 17
x10>9/L
Total Red Cells
4
3.9
5.5 - 8.5
X10>12/L
Haemoglobin
9.7
9.6
12-18
g/dL
Platelets
68
1
200-500
x10>9/L
The dog survived and is well nursed by the lady owner as at Nov 21, 2010. As to the cause, I told her it was difficult to say. The cause would likely be a viral and bacterial cause. The dog had not been vaccinated since she was a puppy and was brought for walks in the past year whereas previously the dog was home most of the time.
BACKGROUND HISTORY OF THIS DOG RECORDED BY ME IN NOV 15, 2010
AT DEATH'S DOOR. THE DOG WITH WHITE GUMS
The thin, hunch-backed 10-year-old Miniature Schnauzer with white gums would not eat. She had been treated 4 times by Vet 1. ACTH tests were normal. Ultrasound indicated possible tumours of the liver, pancreas and spleen. So, the owner was very worried and wanted surgery.
"The dog is not fit for surgery," I advised. "She will just die on the operating table. Look at the white gums. She has severe anaemia. I will do a blood test."
The anaemia was due to low red cell count, low haemoglobin and very low platelet count. She was attended to by Vet 1 from August to November for 4 times and was not eating when the owner consulted me, being referred to by one of my clients.
Incredibly, after an intensive IV drip of saline, glucose, protein, Vit K1, antibiotics including baytril and metronidazole, B complex and iron injections s/c, the dog that lost 1 kg (25% of her weight in the last 4 weeks) was thriving. "She ate a lot and pooped a lot for the last 2 days," the young lady said. "Today, she is not eating. Shall I give her the Re... from Vet 1? It is said to improve her appetite."
What was the cause of this severe anaemia and the low platelet count? I suspect it was either some drugs or septic infection (from virus or bacteria) when the dog was brought downstairs in recent weeks.
During the first consultation with me, the dog screamed when I pressed the very painful disc pain at T/L area and bit me when I palpated the moderately enlarged left submandibular and popliteal lymph node. Her bladder was painful on palpation. Her left kidney was slightly painful. Her left tongue had some ulcers at the back and I took digital pictures to show the owner.
So what was happening to this dog? The lady had only one wish - that this dog would not die on her as she had a recent family bereavement. Yet, the dog's gums were as white as snow when I saw her at first. I did not take a picture then but her gums became a bit pinker 24 hours after the intensive care and injections. So, this dog had come back from death's door. But she is not out of the woods yet. Only time will tell.
UPDATE: No complaints from the young lady. I phoned her twice and the dog was getting better. Short episodes of panting which I attributed to pain in the spinal area. I asked her to give pred 2.5 mg two times per day. No more news from her. No news is good news, usually.
Miniature Schnauzer, Female, Spayed 10 years - White gums
11-Nov-10 Nov 12,10 Ref Range Unit
Total WBC 12.8 6.6 6 to 17 x10>9/L
Haemoglobin 9.7 9.6 12 to 18 g/dL
Red Cells 4 3.9 5.5 to 8.5 X10>12/L
Platelets 68 1 200 to 500 x10>9/L
No platelet clumps seen No platelet clumps seen
Few giant platelets present
Creatinine 47 62 89 to 177
Owner's complaint - poor appetite, lost weight 1 kg in 1 month lost appetite
Weight loss 25% in last month, now 4 kg
Presenting Signs: White gums and tongue
Rectal temp 38.5 C
Palpation: Enlarged left submandibular & popliteal lymph nodes 0.8 cm x 0.8 cm
Bites when left popliteal lymph node was palpated, pain in left kidney and bladder
Blood test results: Anaemia and toxaemia. Viral and/or bacterial cause likely
Platelet count dropped to 1 after 24 hours.
Any chance of survival?
11-Nov-10 Nov 12,10 Ref Range Unit
Total WBC 12.8 6.6 6 to 17 x10>9/L
Haemoglobin 9.7 9.6 12 to 18 g/dL
Red Cells 4 3.9 5.5 to 8.5 X10>12/L
Platelets 68 1 200 to 500 x10>9/L
No platelet clumps seen No platelet clumps seen
Few giant platelets present
Creatinine 47 62 89 to 177
Owner's complaint - poor appetite, lost weight 1 kg in 1 month lost appetite
Weight loss 25% in last month, now 4 kg
Presenting Signs: White gums and tongue
Rectal temp 38.5 C
Palpation: Enlarged left submandibular & popliteal lymph nodes 0.8 cm x 0.8 cm
Bites when left popliteal lymph node was palpated, pain in left kidney and bladder
Blood test results: Anaemia and toxaemia. Viral and/or bacterial cause likely
Platelet count dropped to 1 after 24 hours.
Any chance of survival?
Saturday, November 20, 2010
Business success and worries
Yesterday, I met a young lady from Myanmar who speaks excellent English. She wants to start a dream business bringing artistes and singers from Myanmar to perform in Singapore.
"I have no contacts with the Esplanade and Integrated Resorts," she told me and I was surprised by her remarks. "It is quality of CONTENT not contacts that is important in any business", I advised her. "CONTENT means that your artistes can provide the services that the public wants so that you can make a profit," I said. "As an example, If you represent Michael Jackson, you have CONTENT and there is no shortage of venues."
I define a business as one that is for profit and for non-profit.
All business have the same worries of failures of not being able to pay the varied expenses, whether it is a veterinary practice, travel agency, real estate agency, an animal shelter, entertainment company or non-profit organisation or your own start up.
The following report applies to Travel Agencies but you can see that the factors I wrote is appropriate for the veterinary business in particular but will apply to all business start ups.
Over the last 2 years, I surveyed and observed the many interesting travel agencies in Peninsula Plaza. I also spoke to some of my interesting and successful veterinary clientele in their own and travel business and asked how they can survive the ever increasing intense competition. For the travel agencies, I enquired how they can survive in the cut-throat, price undercutting travel business with hotels and airlines provide direct internet purchase. Here are the main factors which were from an online survey I participated.
FOR THE TRAVEL AGENCY TO WIN AGAINST COMPETITORS
1. PRICES - Cheaper air tickets and hotels.
Vet example: New vet practices under price everybody. At least there are customers rather than no business. The sustainability of the business is not possible unless the vet has deep pockets and net losses are incurred per year.
2. VALUE - Better value or more interesting travel packages.
Vet example: Better equipped like CT scan, ultrasound, digital X-rays, blood testing and others.
3. SERVICES - Providing extra services such as insurance, visa application, vehicle rentals.
Vet example: Blood transfusion, acupuncture, holistic vet.
4. BRANDING - Better reputation and value.
This takes time and relies on the vet's bedside manners, ability and competence. See: A brand name vet practice opens doors...
Some agencies have loyal clientele if they provide 1 and 3 but the business may not be sustainable. The operator keeps looking for loans to cover the operating costs and this results in a bad reputation amongst the community.
FOR THE TRAVEL AGENCY TO FAIL
1. GIVE CREDIT TO CORPORATIONS AND OTHERS. One bad debt in big amount is enough to wipe out all the small margins of profit. Don't be a banker. Collect money first before starting the tour or travel.
Another factor for business success is a good updated website as a marketing and branding tool. I will tell this to the young ones who want to start a business. Many do start a website but fail to nurture and maintain it with CONTENT of relevance and interest every day. Updating of websites is time-consuming. There are better things to do in this time-pressed world of Singapore.
WEBSITE
This is important for any business. The following is my response to an online a survey I participated today.
CONCERNS WHEN STARTING A WEBSITE FOR THE COMPANY
1. High cost of starting up. The problem with the few webmasters I encountered is that the webmaster/company has no relevant experience as justified by portfolios of past clientele. I have not approached the big boys as I just can't afford their services.
2. High cost of maintenance. The webmaster disappears or his company increases fees over the years, just like accountants and auditors.
3. Lack of technical expertise. The start up business owner needs to do his own updating as it is costly to get the webmaster to do it.
4. Lack of traffic and sales from website. This is the least of the worries if the CONTENT is relevant to the prospective clients, is updated and interesting. Search engines do pick out the relevant topics. You can also pay www.google.com
and www.yahoo.com to be listed in the top 10.
Comments: In Singapore, my experience is that affordable webmasters are hard to find. Webmasters charge a lot of money due to the high cost of rentals. It is hard to locate an experienced webmaster with relevant experience. Or at affordable cost unlike in South Korea where I read that many small companies have websites due to lower costs of webmasters and broadband fees.
MY THREE MOST IMPORTANT FEATURES IN A WEBSITE
1. To be able to safely, securely and automatically accept payment online.
2. To increase sales and recognition through social marketing (like Facebook).
An interesting example is http://www.facebook.com/home.php?#!/philea.resort
I was a guest at the Philea Resort and Spa on Nov 6, 2010 and stumbled on its Facebook webpage as I submitted some photos of the Bridal Fair 2010 held at the resort to the marketing manager to forward to the models. It has a facebook page which I believe it common with all good hotels nowadays. Facebook viewing can waste a lot of time but the young generation loves it and are a source of new generation clientele.
3. To increase repeat customers with email promotions and newsletters
OTHER FEATURES
4. To increase customer conversion rate with multimedia presentations
5. To gather feedback and response from customers through company forum. This is interactive and very useful.
6. To build customer loyalty with reward points
7. To survey customers with online quiz and polls
8. To communicate with website visitor with live chat. I find this feature very useful when I had questions about my web hosting with Earthlinks.net in the USA.
9. Others - BRAND BUILDING. I will think a website builds a brand reputation.
HOW MUCH I WILL INVEST IN THE TOP 3 FEATURES
S$3,000. I doubt Singapore webmasters will take this amount. In Singapore, the Landlord keeps increasing rentals and the government agencies keep thinking of new ways to collect fees from the businesses. So, it is difficult for start ups to pay and pay.
The above replies were my participation in an online survey. It was powered by Qualtrics. www.qualtrics.com. I hope this info is useful for the young ones who want to start their dream business.
I asked the young lady who is doing her 3rd year of undergraduate studies in Economics and Finance: "Have you got a name-card?" She said: "No." Well, young lady.
A name card needs to be printed and presented if you want to start a business. This name card permits others to contact you when they need your singers and dancers or refer to the powerful ones at The Esplanade and the Integrated Resorts via networking!
Updates are at www.toapayohvets.com
"I have no contacts with the Esplanade and Integrated Resorts," she told me and I was surprised by her remarks. "It is quality of CONTENT not contacts that is important in any business", I advised her. "CONTENT means that your artistes can provide the services that the public wants so that you can make a profit," I said. "As an example, If you represent Michael Jackson, you have CONTENT and there is no shortage of venues."
I define a business as one that is for profit and for non-profit.
All business have the same worries of failures of not being able to pay the varied expenses, whether it is a veterinary practice, travel agency, real estate agency, an animal shelter, entertainment company or non-profit organisation or your own start up.
The following report applies to Travel Agencies but you can see that the factors I wrote is appropriate for the veterinary business in particular but will apply to all business start ups.
Over the last 2 years, I surveyed and observed the many interesting travel agencies in Peninsula Plaza. I also spoke to some of my interesting and successful veterinary clientele in their own and travel business and asked how they can survive the ever increasing intense competition. For the travel agencies, I enquired how they can survive in the cut-throat, price undercutting travel business with hotels and airlines provide direct internet purchase. Here are the main factors which were from an online survey I participated.
FOR THE TRAVEL AGENCY TO WIN AGAINST COMPETITORS
1. PRICES - Cheaper air tickets and hotels.
Vet example: New vet practices under price everybody. At least there are customers rather than no business. The sustainability of the business is not possible unless the vet has deep pockets and net losses are incurred per year.
2. VALUE - Better value or more interesting travel packages.
Vet example: Better equipped like CT scan, ultrasound, digital X-rays, blood testing and others.
3. SERVICES - Providing extra services such as insurance, visa application, vehicle rentals.
Vet example: Blood transfusion, acupuncture, holistic vet.
4. BRANDING - Better reputation and value.
This takes time and relies on the vet's bedside manners, ability and competence. See: A brand name vet practice opens doors...
Some agencies have loyal clientele if they provide 1 and 3 but the business may not be sustainable. The operator keeps looking for loans to cover the operating costs and this results in a bad reputation amongst the community.
FOR THE TRAVEL AGENCY TO FAIL
1. GIVE CREDIT TO CORPORATIONS AND OTHERS. One bad debt in big amount is enough to wipe out all the small margins of profit. Don't be a banker. Collect money first before starting the tour or travel.
Another factor for business success is a good updated website as a marketing and branding tool. I will tell this to the young ones who want to start a business. Many do start a website but fail to nurture and maintain it with CONTENT of relevance and interest every day. Updating of websites is time-consuming. There are better things to do in this time-pressed world of Singapore.
WEBSITE
This is important for any business. The following is my response to an online a survey I participated today.
CONCERNS WHEN STARTING A WEBSITE FOR THE COMPANY
1. High cost of starting up. The problem with the few webmasters I encountered is that the webmaster/company has no relevant experience as justified by portfolios of past clientele. I have not approached the big boys as I just can't afford their services.
2. High cost of maintenance. The webmaster disappears or his company increases fees over the years, just like accountants and auditors.
3. Lack of technical expertise. The start up business owner needs to do his own updating as it is costly to get the webmaster to do it.
4. Lack of traffic and sales from website. This is the least of the worries if the CONTENT is relevant to the prospective clients, is updated and interesting. Search engines do pick out the relevant topics. You can also pay www.google.com
and www.yahoo.com to be listed in the top 10.
Comments: In Singapore, my experience is that affordable webmasters are hard to find. Webmasters charge a lot of money due to the high cost of rentals. It is hard to locate an experienced webmaster with relevant experience. Or at affordable cost unlike in South Korea where I read that many small companies have websites due to lower costs of webmasters and broadband fees.
MY THREE MOST IMPORTANT FEATURES IN A WEBSITE
1. To be able to safely, securely and automatically accept payment online.
2. To increase sales and recognition through social marketing (like Facebook).
An interesting example is http://www.facebook.com/home.php?#!/philea.resort
I was a guest at the Philea Resort and Spa on Nov 6, 2010 and stumbled on its Facebook webpage as I submitted some photos of the Bridal Fair 2010 held at the resort to the marketing manager to forward to the models. It has a facebook page which I believe it common with all good hotels nowadays. Facebook viewing can waste a lot of time but the young generation loves it and are a source of new generation clientele.
3. To increase repeat customers with email promotions and newsletters
OTHER FEATURES
4. To increase customer conversion rate with multimedia presentations
5. To gather feedback and response from customers through company forum. This is interactive and very useful.
6. To build customer loyalty with reward points
7. To survey customers with online quiz and polls
8. To communicate with website visitor with live chat. I find this feature very useful when I had questions about my web hosting with Earthlinks.net in the USA.
9. Others - BRAND BUILDING. I will think a website builds a brand reputation.
HOW MUCH I WILL INVEST IN THE TOP 3 FEATURES
S$3,000. I doubt Singapore webmasters will take this amount. In Singapore, the Landlord keeps increasing rentals and the government agencies keep thinking of new ways to collect fees from the businesses. So, it is difficult for start ups to pay and pay.
The above replies were my participation in an online survey. It was powered by Qualtrics. www.qualtrics.com. I hope this info is useful for the young ones who want to start their dream business.
I asked the young lady who is doing her 3rd year of undergraduate studies in Economics and Finance: "Have you got a name-card?" She said: "No." Well, young lady.
A name card needs to be printed and presented if you want to start a business. This name card permits others to contact you when they need your singers and dancers or refer to the powerful ones at The Esplanade and the Integrated Resorts via networking!
Updates are at www.toapayohvets.com
245. Neutering risks for a 4-year-old male cat email
E-MAIL TO TOA PAYOH VETS DATED NOV 19, 2010
Hi Judy,
I would like to know if a cat that's 4 years old still suitable to do neutering? Will there be any risk? How's much will be the operation cost?
Regards,
Name of owner
E-MAIL FROM TOA PAYOH VETS DATED NOV 19, 2010
I am Dr Sing from Toa Payoh Vets, www.toapayohvets.com
Thank you for your email. A healthy cat at 4 years old can be neutered.
There is normally no risk if the cat is healthy (take blood test to check liver, kidney and complete blood test if you want to, before operation.The cost is around $150). In 100% of the cats neutered by me in the past 30 years (Toa Payoh Vets) was started by me in 1982, I have no male cats dying after neutering and I am quite sure this is the same with other vets in Singapore.
Prior to surgery, the cat will be examined for general health before surgery by taking a history of his past health, a general examination, palpation for abnormalities inside the cat, taking of temperature, pulse and respiratory rate and weighing him. If he fails the general examination, he will not be operated.
The main risk will be infection after surgery, from my observations of cats spayed in countries where there are no facilties for aseptic surgery and no antibiotics post-operation. Infections can kill a cat after surgery.
Surgery and anesthesia at Toa Payoh Vets for male cat neutering costs around $75.00. Add $30 for post-op antibiotic and pain-killer injection.
Estimated total will be around $105 for most clients who don't want blood test done. A pre-op blood test at this age or before anaesthesia and surgery is advised. The complete blood test costs around $150.
Please make appointment by tel 6254-3326. No food and water for the cat after 10 p.m, the night before the surgery and give the cat a good wash at the scrotal area.
Hi Judy,
I would like to know if a cat that's 4 years old still suitable to do neutering? Will there be any risk? How's much will be the operation cost?
Regards,
Name of owner
E-MAIL FROM TOA PAYOH VETS DATED NOV 19, 2010
I am Dr Sing from Toa Payoh Vets, www.toapayohvets.com
Thank you for your email. A healthy cat at 4 years old can be neutered.
There is normally no risk if the cat is healthy (take blood test to check liver, kidney and complete blood test if you want to, before operation.The cost is around $150). In 100% of the cats neutered by me in the past 30 years (Toa Payoh Vets) was started by me in 1982, I have no male cats dying after neutering and I am quite sure this is the same with other vets in Singapore.
Prior to surgery, the cat will be examined for general health before surgery by taking a history of his past health, a general examination, palpation for abnormalities inside the cat, taking of temperature, pulse and respiratory rate and weighing him. If he fails the general examination, he will not be operated.
The main risk will be infection after surgery, from my observations of cats spayed in countries where there are no facilties for aseptic surgery and no antibiotics post-operation. Infections can kill a cat after surgery.
Surgery and anesthesia at Toa Payoh Vets for male cat neutering costs around $75.00. Add $30 for post-op antibiotic and pain-killer injection.
Estimated total will be around $105 for most clients who don't want blood test done. A pre-op blood test at this age or before anaesthesia and surgery is advised. The complete blood test costs around $150.
Please make appointment by tel 6254-3326. No food and water for the cat after 10 p.m, the night before the surgery and give the cat a good wash at the scrotal area.
Tuesday, November 16, 2010
244. At death's door - 3 cases
1. Case 1. The aggressive self-diagnosing breeder. I had stopped providing vet services to all dog breeders for the past 2 years. What most of them want was usually very cheap services.
This particular breeder brought in a Shih Tzu on Sunday at 5 pm. His vet was not available. He said he had X-rayed the dam at another practice but the X-ray showed 4 pups. He did not bring the X-ray saying he was busy. He suspected there was a 5th pup and could feel it. 4 pups were born naturally on Saturday and were OK. That was 24 hours ago.
I palpated a bony mass. "The pup is dead," I advised as it was past 24 hours from the last pup and the foetal lump felt 'bony' and that meant the water bag had broken.
"There is no point in giving oxytocin injection. Your dam needs a Caesarean section." This breeder was insistent in having an oxytocin injection. I did not throw him out as he did not accept my advice. I gave the injection. After one hour, the dog did not produce any pup. My first assistant advised a Caesarean and he accepted the need for one since no pups were produced.
The pup was smeared with dark greenish glue from the melted placenta. It had no amniotic sac and was stiff as in rigor mortis. This breeder wanted no more veterinary treatment like IV drip and antibiotics IV. He wanted to bring back the dam and wanted to pay only $250. "The new vets are charging less," he said. He became aggressive as his demands were not agreed upon. It was unpleasant. This is the reason I have had stopped dealing with dog breeders.
The next morning, the dog died. The owners were very unhappy. A dog's death is an extemely emotional experience for the owners and for the vet. This was a case where the owner entrusted this breeder to handle their dog's accidental pregnancy. He said he had X-rayed but would not produce the X-ray.
I have barred this breeder from coming to Toa Payoh Vets and told my associate vets that it would be best not to accept breeders at all. It was just not a sustainable practice to offer $250 Caesarean sections and lose money and respect from breeders who want to cut corners.
Case 2. The cat with nasal cancer. The cat went home the next day after surgery to excise most of the tumours. The owner phoned me today and said that the cat was eating. The nose bleeding on Sunday morning after I had pulled out the swab which stopped inside the nose bleeding was no more. The family had decided on no chemotherapy. "Can you do surgery when the cancer returns?" the father asked. "No," I said. "There is a big hole on the top of the nose, now covered by the skin. This malignant tumour doubles in size every 7 days and I expect that the cat will not live long." Chemotherapy is not guaranteed and may cause the cat to lose appetite. So, what's the advice?
"Try chemotherapy in low dosage first," I advised. There was nothing to lose as the wife was quite close to this cat. Chemotherapy does not cost thousands of dollars unlike the case in human cancer treatment. "Euthanasia will be the only option when the cancer recurs and bacterial infections of the right nostril causes pain and suffering," I said. This cat had no infection from this surgery because she had been on antibiotics 6 days before surgery and after surgery. So she responded well and could eat and drink normally at home post-operation, much to the happiness of the wife. But death is really at the door. If chemotherapy helps, it will be a happy ending.
FOR MY RECORD
Weight: 3.5 kg. Cat.
Anaesthesia. Domitor 0.1 ml IV. Zoletil 100 0.1 ml IV. Atropine 0.5ml SC. Intubate. Gave oxygen. Duration of anaesthesia was nearly one hour. A few seconds of isoflurane gas was given towards the end of surgery. It was taking one hour to do it. IV saline and baytril drip given 24 hours.
Post-operation.
No Antisedan antidote was given so that the cat could be sedated and wake up with less pain. The cat was observed breathing normally through its left nostril (forceps into nostril confirming no cancer cells from right nostril). He slept for many hours and was fresh as a daisy on the next morning after surgery.
Surgery on Friday at 4 pm. Incise with scalpel. Undermine skin. Nasal tumour grows from inside the nose, break through nasal bone is 2.5 cm x 1 cm long and much deeper inside the nose.
Electro-surgery separates tumour as much as possible from nasal bone. Excised. Large hole in nasal bone eaten by the tumour seen. Around 1 cm x 0.5 cm. Round fatty tumour cells seen from inside the nose and excised.
I put a gauze swab into the nasal hole and pull it out from the nostril using forceps (see picture at www.toapayohvets.com). This stops bleeding. Electro-coagulation of the tissues inside the nose helps but does not stop the bleeding.
Goes home on Sunday at 10 am after I pull out the gauze swab. I smelled the gauze swab. Not smelly and this is a good sign that there is no bacterial infection. Red blood oozed out of the nostril. Owner asked to wipe the blood off regularly. (The bleeding stopped on Monday).
Case 3. The dog with white gums
The thin, hunch-backed 10-year-old Miniature Schnauzer with white gums would not eat. She had been treated 4 times by Vet 1. ACTH tests were normal. Ultrasound indicated possible tumours of the liver, pancreas and spleen. So, the owner was very worried and wanted surgery.
"The dog is not fit for surgery," I advised. "She will just die on the operating table. Look at the white gums. She has severe anameia. I will do a blood test."
The anaemia was due to low red cell count, low haemoglobin and very low platelet count. She was attended to by Vet 1 from August to November for 4 times and was not eating when the owner consulted me, being referred to by one of my clients.
Incredibly, after an intensive IV drip of saline, glucose, protein, Vit K1, antibiotics including baytril and metronidazole, B complex and iron injections s/c, the dog that lost 1 kg (25% of her weight in the last 4 weeks) was thriving. "She ate a lot and pooped a lot for the last 2 days," the young lady said. "Today, she is not eating. Shall I give her the Re... from Vet 1? It is said to improve her appetite."
What was the cause of this severe anaemia and the low platelet count? I suspect it was either some drugs or septic infection (from virus or bacteria) when the dog was brought downstairs in recent weeks.
During the first consultation with me, the dog screamed when I pressed the very painful disc pain at T/L area and bit me when I palpated the moderately enlarged left submandibular and popliteal lymph node. Her bladder was painful on palpation. Her left kidney was slightly painful. Her left tongue had some ulcers at the back and I took digital pictures to show the owner.
So what was happening to this dog? The lady had only one wish - that this dog would not die on her as she had a recent family bereavement. Yet, the dog's gums were as white as snow when I saw her at first. I did not take a picture then but her gums became a bit pinker 24 hours after the intensive care and injections. So, this dog had come back from death's door. But she is not out of the woods yet. Only time will tell.
This particular breeder brought in a Shih Tzu on Sunday at 5 pm. His vet was not available. He said he had X-rayed the dam at another practice but the X-ray showed 4 pups. He did not bring the X-ray saying he was busy. He suspected there was a 5th pup and could feel it. 4 pups were born naturally on Saturday and were OK. That was 24 hours ago.
I palpated a bony mass. "The pup is dead," I advised as it was past 24 hours from the last pup and the foetal lump felt 'bony' and that meant the water bag had broken.
"There is no point in giving oxytocin injection. Your dam needs a Caesarean section." This breeder was insistent in having an oxytocin injection. I did not throw him out as he did not accept my advice. I gave the injection. After one hour, the dog did not produce any pup. My first assistant advised a Caesarean and he accepted the need for one since no pups were produced.
The pup was smeared with dark greenish glue from the melted placenta. It had no amniotic sac and was stiff as in rigor mortis. This breeder wanted no more veterinary treatment like IV drip and antibiotics IV. He wanted to bring back the dam and wanted to pay only $250. "The new vets are charging less," he said. He became aggressive as his demands were not agreed upon. It was unpleasant. This is the reason I have had stopped dealing with dog breeders.
The next morning, the dog died. The owners were very unhappy. A dog's death is an extemely emotional experience for the owners and for the vet. This was a case where the owner entrusted this breeder to handle their dog's accidental pregnancy. He said he had X-rayed but would not produce the X-ray.
I have barred this breeder from coming to Toa Payoh Vets and told my associate vets that it would be best not to accept breeders at all. It was just not a sustainable practice to offer $250 Caesarean sections and lose money and respect from breeders who want to cut corners.
Case 2. The cat with nasal cancer. The cat went home the next day after surgery to excise most of the tumours. The owner phoned me today and said that the cat was eating. The nose bleeding on Sunday morning after I had pulled out the swab which stopped inside the nose bleeding was no more. The family had decided on no chemotherapy. "Can you do surgery when the cancer returns?" the father asked. "No," I said. "There is a big hole on the top of the nose, now covered by the skin. This malignant tumour doubles in size every 7 days and I expect that the cat will not live long." Chemotherapy is not guaranteed and may cause the cat to lose appetite. So, what's the advice?
"Try chemotherapy in low dosage first," I advised. There was nothing to lose as the wife was quite close to this cat. Chemotherapy does not cost thousands of dollars unlike the case in human cancer treatment. "Euthanasia will be the only option when the cancer recurs and bacterial infections of the right nostril causes pain and suffering," I said. This cat had no infection from this surgery because she had been on antibiotics 6 days before surgery and after surgery. So she responded well and could eat and drink normally at home post-operation, much to the happiness of the wife. But death is really at the door. If chemotherapy helps, it will be a happy ending.
FOR MY RECORD
Weight: 3.5 kg. Cat.
Anaesthesia. Domitor 0.1 ml IV. Zoletil 100 0.1 ml IV. Atropine 0.5ml SC. Intubate. Gave oxygen. Duration of anaesthesia was nearly one hour. A few seconds of isoflurane gas was given towards the end of surgery. It was taking one hour to do it. IV saline and baytril drip given 24 hours.
Post-operation.
No Antisedan antidote was given so that the cat could be sedated and wake up with less pain. The cat was observed breathing normally through its left nostril (forceps into nostril confirming no cancer cells from right nostril). He slept for many hours and was fresh as a daisy on the next morning after surgery.
Surgery on Friday at 4 pm. Incise with scalpel. Undermine skin. Nasal tumour grows from inside the nose, break through nasal bone is 2.5 cm x 1 cm long and much deeper inside the nose.
Electro-surgery separates tumour as much as possible from nasal bone. Excised. Large hole in nasal bone eaten by the tumour seen. Around 1 cm x 0.5 cm. Round fatty tumour cells seen from inside the nose and excised.
I put a gauze swab into the nasal hole and pull it out from the nostril using forceps (see picture at www.toapayohvets.com). This stops bleeding. Electro-coagulation of the tissues inside the nose helps but does not stop the bleeding.
Goes home on Sunday at 10 am after I pull out the gauze swab. I smelled the gauze swab. Not smelly and this is a good sign that there is no bacterial infection. Red blood oozed out of the nostril. Owner asked to wipe the blood off regularly. (The bleeding stopped on Monday).
Case 3. The dog with white gums
The thin, hunch-backed 10-year-old Miniature Schnauzer with white gums would not eat. She had been treated 4 times by Vet 1. ACTH tests were normal. Ultrasound indicated possible tumours of the liver, pancreas and spleen. So, the owner was very worried and wanted surgery.
"The dog is not fit for surgery," I advised. "She will just die on the operating table. Look at the white gums. She has severe anameia. I will do a blood test."
The anaemia was due to low red cell count, low haemoglobin and very low platelet count. She was attended to by Vet 1 from August to November for 4 times and was not eating when the owner consulted me, being referred to by one of my clients.
Incredibly, after an intensive IV drip of saline, glucose, protein, Vit K1, antibiotics including baytril and metronidazole, B complex and iron injections s/c, the dog that lost 1 kg (25% of her weight in the last 4 weeks) was thriving. "She ate a lot and pooped a lot for the last 2 days," the young lady said. "Today, she is not eating. Shall I give her the Re... from Vet 1? It is said to improve her appetite."
What was the cause of this severe anaemia and the low platelet count? I suspect it was either some drugs or septic infection (from virus or bacteria) when the dog was brought downstairs in recent weeks.
During the first consultation with me, the dog screamed when I pressed the very painful disc pain at T/L area and bit me when I palpated the moderately enlarged left submandibular and popliteal lymph node. Her bladder was painful on palpation. Her left kidney was slightly painful. Her left tongue had some ulcers at the back and I took digital pictures to show the owner.
So what was happening to this dog? The lady had only one wish - that this dog would not die on her as she had a recent family bereavement. Yet, the dog's gums were as white as snow when I saw her at first. I did not take a picture then but her gums became a bit pinker 24 hours after the intensive care and injections. So, this dog had come back from death's door. But she is not out of the woods yet. Only time will tell.
Photography tips:Bridal Models
PHOTOGRAPHY TIPS
November 6, 2010. Philea Resort & Spa, Melaka, Bridal Fair 2010 Photography Contest. I was a guest at the Philea, taking a 3-day 2-night break from my veterinary work. The pro-active marketing manager saw me at the ballroom where the Bridal Fair was held and invited me to register for the Photography Contest. The bridal models in the ballroom showed off the bridal dresses. The Contest was outdoors at 6 p.m. It started to drizzle around 6 p.m.
The evening sky was gloomy. Lighting was poor as the sky was overcast at 6 p.m. It was my first time photographing bridal models or any human models. I wanted to give up. But a Muar photographer encouraged me to get on with it.
Tips from this Muar photographer were helpful. These were "focus on the eyes" and "eye contact" to get a lively and sharp picture. "Shout 'hello' just before you click to get the model's attention and her eye contact," he advised me.
I didn't dare to shout "hello" before clicking. I waited for the eye contact to happen by chance and there were 3 below.
One photographer shouted "Marina," and the model turned her head in his direction. I learnt about the tricks of the trade in Malacca. For my animal photography, shouting at a cat or dog for eye contact photography usually does not work!
I did not submit any photo for the Contest which had the theme of "Highlight of the beauty environment and exciting premises together with beautiful model as bridal". To satisfy the theme, a close-up of the bridal models would not qualify. It would need to show the environment and premises of the Resort and the best picture I had was that of the bridal couple directed by the photographers to stand at the edge of the pool. I captured this picture as I was moving away to take pictures of other models up the hill. I quickly snapped this scene. To me, it had an excellent composition, action of the pro-active photographer risking his camera to command the hard working bridal couple to take a risk on the rocky pebbles which are meant to discourage people walking on them. The lone photographer faced the bridal couple, reminding me of the famous Tiananmen Square Protests of 1989 photo of a man facing the army tanks, as in: http://en.wikipedia.org/wiki/Tiananmen_Square_protests_of_1989.
You can see that the photographer near the model was a pro-active type. The one in orange T-shirt ventured out a bit to risk his camera falling into the pool with him should he slip and fall. The others (hidden in the right) preferred not to take risk and stayed on firm ground. This picture shows the beautiful pool and the cascading waterfall features of Philea Resort and Spa and the bridal model. It might be on the final list to win a prize, in my opinion. Maybe not. One has to be hands-on to learn a new trade as reading all the photography magazines will not be sufficient as to go to be battle-tested.
I used "P" Mode and set the ISO to 3200. I was surprised to get some "good pictures" for my readers. These were the pictures where I was at the right place at the right time and got the right point of view without obstruction from the various Malaccan photographers.
Update and more photos are at:
www.toapayohvets.com/philea.htm
http://en.wikipedia.org/wiki/Tiananmen_Square_protests_of_1989
--------------------
6 MAR 2024 PHOTO OF TIANANMEN SQUARE
Photo taken from drive-by taxi using Canon R5. Use TV Mode. I doubt the iPhone 15 can take sharp images from a moving taxi.
Great idea from Kat to take photos from a taxi as tight security prevented tourists from getting near the Square where the Communist Party was hosting its annual political event "Two Sessions" with President Xi Jinping.
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